Plasma Brain-Derived Neurotrophic Factor Levels in Newborn Infants with Neonatal Abstinence Syndrome.
Plasma Brain-Derived Neurotrophic Factor Levels in Newborn Infants with Neonatal Abstinence Syndrome.
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DOI：
10.3389/fped.2017.00238
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发表时间：
2017
影响因子：
2.6
通讯作者：
Sithisarn T
中科院分区：
文献类型：
--
作者：
Subedi L;Huang H;Pant A;Westgate PM;Bada HS;Bauer JA;Giannone PJ;Sithisarn T
脑源性神经营养因子（BDNF）是一种促进神经元生长和存活的生长因子。胎儿接触阿片类药物可导致产后戒断综合征，即新生儿戒断综合征（NAS）。临床前和临床研究表明，阿片类药物暴露与成人脑和血清中BDNF表达的改变之间存在关联。然而，到目前为止，还没有关于阿片类药物暴露对子宫内暴露于阿片类药物的婴儿BDNF水平的影响以及BDNF水平是否与NAS的严重程度相关的数据。比较NAS和非NAS患儿血浆BDNF水平，并确定BDNF水平与NAS严重程度的相关性。这是一项前瞻性队列研究，不涉及干预。入选的是≥35孕周的婴儿。使用酶联免疫吸附测定技术从生命48小时内抽取的血液样本中测量BDNF水平。NAS的严重程度取决于住院时间和治疗NAS所需药物的数量。67名婴儿入组，34名NAS和33名非NAS。两组的平均胎龄没有差异。NAS患儿的平均出生体重显著低于非NAS患儿（3070±523比3340±459 g， p = 0.028）。NAS组平均BDNF水平为252.2±91.6 ng/ml，显著高于非NAS组的211.3±66.3 ng/ml （p = 0.04）。需要一种或多种药物治疗的NAS患儿的BDNF水平无差异（254±91比218±106 ng/ml， p = 0.47）。NAS患儿BDNF水平与住院时间无相关性（p = 0.68）。总体而言，BDNF水平与NAS评分之间无显著相关性，除了入院后约15小时（相关性0.35,p = 0.045）。与非NAS婴儿相比，NAS婴儿在前48小时内血浆BDNF水平显著升高。血浆BDNF水平与NAS严重程度之间的相关性值得进一步研究。这些结果表明BDNF可能在子宫阿片类药物暴露后的戒断过程中发挥神经调节作用。
Brain-derived neurotrophic factor (BDNF) is a type of growth factor that promotes growth and survival of neurons. Fetal exposure to opiates can lead to postnatal withdrawal syndrome, which is referred as neonatal abstinence syndrome (NAS). Preclinical and clinical studies have shown an association between opiates exposure and alteration in BDNF expression in the brain and serum levels in adult. However, to date, there are no data available on the effects of opiate exposure on BDNF levels in infant who are exposed to opiates in utero and whether BDNF level may correlate with the severity of NAS. To compare plasma BDNF levels among NAS and non-NAS infants and to determine the correlation of BDNF levels and the severity of NAS. This is a prospective cohort study with no intervention involved. Infants ≥35 weeks of gestation were enrolled. BDNF level was measured using enzyme-linked immunosorbent assay technique from blood samples drawn within 48 h of life. The severity of NAS was determined by the length of hospital stay, number of medications required to treat NAS. 67 infants were enrolled, 34 NAS and 33 non-NAS. Mean gestational age did not differ between the two groups. Mean birth weight of NAS infants was significantly lower than the non-NAS infants (3,070 ± 523 vs. 3,340 ± 459 g, p = 0.028). Mean BDNF level in NAS group was 252.2 ± 91.6 ng/ml, significantly higher than 211.3 ± 66.3 ng/ml in the non-NAS group (p = 0.04). There were no differences in BDNF levels between NAS infants that required one medication vs. more than one medication (254 ± 91 vs. 218 ± 106 ng/ml, p = 0.47). There was no correlation between the BDNF levels and length of hospital stay (p = 0.68) among NAS infants. Overall, there were no significant correlations between BDNF levels and NAS scores except at around 15 h after admission (correlation 0.35, p = 0.045). Plasma BDNF level was significantly increased in NAS infants during the first 48 h when compared to non-NAS infants. The correlations between plasma BDNF levels and the severity of NAS warrant further study. These results suggest that BDNF may play a neuromodulatory role during withdrawal after in utero opiate exposure.
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